Feasibility of routine application of low-radiation CT dynamic volume perfusion imaging with high concentration iodine contrast agent in upper abdomen / 中华放射学杂志

ABSTRACT

Objective:To evaluate the application of one-stop dynamic volume perfusion CT (dVPCT) in upper abdomen, and its feasibility of replacing conventional enhanced CT, perfusion, and angiography.Methods:A total of 94 patients with upper abdominal perfusion examinations were retrospectively enrolled in Deyang People's Hospital of Sichuan Province from April 2017 to June 2019. The data of another 64 patients underwent routine upper abdominal enhancement with 64-slice CT (28 patients) and dual-source CT (26 patients) were analyzed in the same period. The radiation dose and image quality were compared. According to different contrast agent concentration and dosage, 4 perfusion groups and 2 conventional enhanccement groups were divided, including 60 ml iohexol group (350 mg/ml) and 60 ml ultravist group (370 mg/ml), 60 ml and 80 ml iomeprol group (400 mg/ml), 64-slice routine group and dual-source CT routine group. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the liver, pancreas and abdominal aorta images in the arterial and portal vein phases were measured by two radiologists in a blinded way. Subjective image quality was evaluated by two radiologists using a 5-point Likert Scale in a blinded method. Statistical analysis was performed using analysis of variance and kappa test. Imaging findings and typical cases of perfusion were retrospectively analyzed.Results:Radiation dose: the effective dose of each perfusion group was lower than that of the 64-slice spiral CT scan, but higher than that of the dual-source CT routine scan. The SNR and CNR of the 80 ml iomeprol dVPCT group were better than that of 64-slice spiral CT and dual-source CT routine scan ( P<0.05), and were better than that of 60 ml iohexol, ultravist and iomeprol dVPCT groups ( P<0.05). However, the subjective index was lower than that of the dual-source CT routine scan group ( P<0.05). The comprehensive information of multi-phase images, vascular images and perfusion quantitative parameters of volume perfusion data reconstruction in this group is superior to conventional enhanced CT in the detection of lesions, visualization of normal tissues and blood vessels. Conclusion:One-stop dVPCT imaging of the upper abdomen has lower radiation dose with good image quality and more diagnostic information. dVPCT with 80 ml Iomeprol (400 mg/ml) can obtain much better images.